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General NPI Number Information
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NPI Number | 1225120876
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Entity Type | Individual
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Provider Name | ALEX ZEVAN III DC, FIACA, DABCI
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 09/15/2009
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Provider Practice Location Address
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Address Line | 109 1ST ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1219
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Country | US
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Telephone | 630-539-5822
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Fax | 630-539-5823
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Provider Business Mailing Address
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Address Line | PO BOX 6548
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-6548
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Country | US
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Telephone | 630-539-5822
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Fax | 630-539-5823
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 038-007306
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License Number State | IL
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